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Pizzato S, Sergi G, Bolzetta F, De Rui M, De Ronch I, Carraro S, Berton L, Orr E, Imoscopi A, Perissinotto E, Coin A, Manzato E, Veronese N. Effect of weight loss on mortality in overweight and obese nursing home residents during a 5-year follow-up. Eur J Clin Nutr 2015; 69:1113-8. [PMID: 25758838 DOI: 10.1038/ejcn.2015.19] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND/OBJECTIVES The objective of this study was to ascertain the effect of weight loss over the course of 1 year on 5-year mortality in old nursing home (NH) residents in different classes of body mass index (BMI). SUBJECTS/METHODS A longitudinal study was conducted on 161 NH residents aged ⩾ 70 years at the Istituto di Riposo per Anziani, Padova, Italy. Data were collected using a comprehensive geriatric assessment at baseline and at a 1-year follow-up visit. Mortality was recorded over a 5-year follow-up. We divided our sample into four groups using as cutoffs a BMI of 25 and a weight gain or loss of 5% at 1 year (BMI ⩾ 25 and weight stable/gain, BMI ⩾ 25 and weight loss, BMI<25 and weight stable/gain and BMI <25 and weight loss). RESULTS People with a BMI ⩾ 25 and weight loss suffered the worst decline in activities of daily living, whereas those with a BMI <25 and weight loss had the most significant decline in nutritional status, which coincided with the worst decline in the Multidimensional Prognostic Index among the groups whose weight changed. Compared with those with a BMI ⩾ 25 and weight stable/gain (reference group), those with a BMI <25 were at the highest risk of dying (in association with weight loss: hazard ratio HR=3.60, P=0.005; in association with weight stable/gain: HR=2.45, P=0.01), and the mortality risk was also increased in people with a BMI ⩾ 25 and weight loss (HR=1.74, P=0.03). CONCLUSIONS In conclusion, weight loss increases the mortality risk in frail, disabled NH residents, even if they are overweight or obese.
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Affiliation(s)
- S Pizzato
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - G Sergi
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - F Bolzetta
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - M De Rui
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - I De Ronch
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - S Carraro
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - L Berton
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - E Orr
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - A Imoscopi
- Istituto di Riposo per Anziani, Padova, Italy
| | - E Perissinotto
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padova, Padova, Italy
| | - A Coin
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - E Manzato
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - N Veronese
- Department of Medicine-DIMED, Geriatrics Division, University of Padova, Padova, Italy
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Prevalence and Measures of Nutritional Compromise Among Nursing Home Patients: Weight Loss, Low Body Mass Index, Malnutrition, and Feeding Dependency, A Systematic Review of the Literature. J Am Med Dir Assoc 2013; 14:94-100. [DOI: 10.1016/j.jamda.2012.10.012] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 10/18/2012] [Accepted: 10/20/2012] [Indexed: 02/02/2023]
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Weintraub NT, Charette S. Encouraging geriatric medicine fellows to write review articles: a description of our experience. J Am Med Dir Assoc 2008; 9:215-8. [PMID: 18457796 DOI: 10.1016/j.jamda.2007.12.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 12/13/2007] [Indexed: 10/22/2022]
Abstract
Medical education in the United States develops many skills, but writing is not usually one of them. At the UCLA Multicampus Division of Geriatrics, we recently instituted a project that attempts to provide the opportunity for each of our Geriatric Medicine fellows to write and publish a review article. We report our experiences of the first 3 years of this program in an effort to share our successes, our shortcomings and our impressions.
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Affiliation(s)
- Nancy T Weintraub
- Greater Los Angeles Veterans Affairs Medical Center, Geriatric Research Education Clinical Center, Sepulveda, CA, USA.
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